The Efficiency of Telemedicine to Optimize Metabolic Control in Patients with Type 1 Diabetes Mellitus: Telemed Study
Open accessAbstract
Objective: This study evaluated the impact of an Internet-based telematic system on the economic and clinical management of patients with type 1 diabetes mellitus. Research Design and Methods: This 6-month prospective, randomized, comparative, open, multicenter study included patients with type 1 diabetes >18 years old treated with multiple insulin doses and with a glycated hemoglobin (HbA 1c ) level of >8%. We compared an intervention group (IG) (two face-to-face and five telematic appointments) with a control group (CG) (seven face-to-face appointments). The variables studied were (1) patient and healthcare team costs, (2) metabolic control, (3) knowledge of diabetes, (4) quality of life, and (5) self-care treatment adherence. Results: Of the 154 patients included, 118 (76.6%) completed the study (IG, 54; CG, 64). The time used by the CG to follow the program was 823±645 min versus 353±222 min in the IG ( P <0.0001). Compared with the CG, the IG required less healthcare time from the professionals (288±105 min vs. 232±89 min; P <0.001). HbA 1c improved in both groups (IG, 9.2±1.5% [77.0±17.0 mmol/mol] vs. 8.7±1.5% [71.6±17.0 mmol/mol] [ P <0.001]; CG, 9.2±0.9% [77.0±10.0 mmol/mol] vs. 8.6±0.9% [70.5±10.0 mmol/mol] [ P <0.001], as did knowledge and self-care treatment adherence. Conclusions: The use of interactive telematic appointments in subjects with type 1 diabetes and inadequate metabolic control is an efficient strategy, providing results comparable to those of face-to-face appointments in relation to improvement in glycemic control, knowledge acquisition, and self-care treatment adherence, with a significant reduction in the time used, especially by patients.
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Previous research suggests that components of virtual care interventions lead to positive outcomes for people with type 2 diabetes such as improved blood glucose control and knowledge to manage their diabetes.
“Previous research suggests that components of virtual care interventions lead to positive outcomes for people with type 2 diabetes such as improved blood glucose control and knowledge to manage their diabetes [9, 10].”
From Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis (2025) · cites this paper as [9]
The Clinical evolution section (page not provided) reports improved HbA1c and diabetes-knowledge scores in the telemedicine group, but the participants had type 1 diabetes, not type 2. Both the telemedicine and face-to-face groups improved, so the study does not establish that a particular virtual-care component caused the gains. (LLM, conf=0.90)
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- Authors
- Esmatjes, E., Jansà, M., Roca, D., Pérez-Ferre, N., del Valle, L., Martínez-Hervás, S., Ruiz de Adana, M., Linares, F., Batanero, R., Vázquez, F., Gomis, R., de Solà-Morales, O., & for the Telemed-Diabetes Group
- Affiliations
- Hospital Clínic de Barcelona (ES)
- University of Barcelona
- San Carlos Hospital Clinic
- University of Valencia
- Carlos Haya University Hospital
- Cruces University Hospital
- University of the Basque Country (ES)
- Health Institute Technology Transfer
- Corresponding author
- Esmatjes, Enric
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2014-07
- Volume
- 16
- Issue
- 7
- Pages
- 435-441
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- OpenAlex
- W185917258
- Cited by
- 64
- References
- 0
- Citations by year
- 2025: 4 · 2024: 2 · 2023: 5 · 2022: 8 · 2021: 8 · 2020: 5 · 2019: 7 · 2018: 4 · 2017: 7 · 2016: 6 · 2015: 5 · 2014: 3
- FWCI
- 6.94
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Diabetes Technology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (acceptedVersion)
- Funders
- Instituto de Salud Carlos III
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 1 diabetes, telemedicine, glycemic control, HbA1c, health care costs, patient time, diabetes knowledge, self-care adherence, quality of life, remote patient monitoring
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Health Knowledge, Attitudes, Practice, Male, Patient Education as Topic, Prospective Studies, Quality of Life, Self Care, Spain, Program Evaluation, Telemedicine, Internet, Medication Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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